Special Share Loan Application

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Note

Must be a member with at least $150 on primary shares. Must be able to service loan via salary deduction. Loan amounts between $500 and $20,000. Interest rates from 12.5% to 15%. Each loan request must be accompanied with a current job letter and pay slip.

Personal Information

Member Number *

Applicant Name *

First

Last

Mobile Phone *

Work Phone

Email *

Applicant Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Employment Information

Employer *

Employee # *

Rank / Position *

Length of Service (yrs) *

Retirement Date *

Loan Information

Amount Applying For *

Date Required *

Loan Purpose *

Consolidation of Debts
Home Improvement / Repairs
Building Materials
Purchase / Repair of Vehicle
License / Insurance of Vehicle
Legal Fees
Vacation / Travel
Purchase / Repair of Household Items
Business Investments
Wedding Expenses
Funeral Expenses
Shopping
Dental Expenses
Family Emergencies
School Fees / Supplies
Medical Expenses
Other

Please Specify Loan Purpose *

Payroll Information

Gross Pay *

Note: This is your total salary before any deductions. This must be taken from your current pay slip which must also be uploaded for verification.

Net Pay *

Note: This is your pay after all deductions. This must be taken from your current pay slip which must also be uploaded.

Job Letter / Pay Slip *

Click or drag files to this area to upload. You can upload up to 5 files.

Credit Check

Credit Check Consent *

I consent to have my credit score obtained by BLECCU for the purpose of qualifying for the loan

Account Debit *

I also consent for my account to be debited the amount of $16.50 per report (VAT inclusive) at the time the report is generated.

Signature *

Clear Signature

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